NATIONAL POPULATION

POLICYSUBMITTED BY :MS BALKEEJ KAUR

M.Sc.(N) 2ND YEAR

AIMS,CON

SRI MUKTSAR SAHIB

POLICY

What is a Policy?

Set of Ideas or Plans that is used as a basis for decision making;

Attitude and actions of an organization regarding a particular issue;

General Statement of understanding which guide decision making.

Cont…..

It is more than mere statement of goals:

How the stated goals can be achieved?

Who will carry out the tasks?

In what manner?

BASIS FOR A POLICY:

Set of Values

Commitments

Assessment of current situation

Image of a desired future situation

Four stages of Policy Process

Problem Identification and Issue Recognition

Policy Formulation

Policy Implementation

Policy Evaluation

Policies related to Health Sector

National Health Policy

Nutrition Policy

Women Policy

Training Policy

Population Policy

What is Population Policy?

Measures formulated by a range of social institutions including Government which may influence the size, distribution or composition of human population (Driver,1972).

A deliberate effort by a national government to influence the demographic variables like fertility, mortality and migration (Organski & Organski,1961)

A set of Coordinated laws aimed at reaching some demographic goal (Biurgeois-Pichat,1974

NEED FOR POPULATION POLICY IN INDIA:

NEED FOR POPULATION POLICY IN INDIA:

On 11th May, 2000, India had 1 billion (100 crores) people, i.e., 16 percent of the world’s population on 2.4 percent of the globe’s land area.

If current trends continue, India may overtake China by 2045, to become the most populous country in the world.

Global population : ↑ 3 folds during this century (from 2 to 6 billion)

Population of India : ↑ nearly 5 times (from 238 million to 1 billion), during the same period.

Stabilizing population is an essential requirement for promoting sustainable development with more equitable distribution .

CAUSES OF HIGH POPULATION GROWTH:

A large size of population in the reproductive age group (estimated contribution 58 percent).

Higher fertility due to unmet needs of contraception (estimated contribution 20 percent).

High desire for fertility due to high infant mortality rate (estimated contribution 20 percent) .

Approximately 50 percent of the girls marry below the age of 18 years, resulting in a typical reproductive pattern of “too early, too frequent, too many.”

Preference for male child.

More children are preferred by poor parents as more workforce.

NATIONAL POPULATION POLICY AND NATIONAL POPULATION PROGRAMME

2000 – India Projected 1 Billion People on 2.4% of Globe’s Land Area

India's current annual increase in population of 15.5 million is large enough to neutralize efforts to conserve the resource endowment and environment.

Introduction

National Population Policy -Milestones

1940- The sub committee on Population , appointed by the National Planning Committee, considered ‘ Family Planning and limitation of children’ essential for the interest of social economy, family happiness and national planning.

1946- The Bhore Committee reported that control of disease and famine would cause a serious problem of population growth.

1951- The Draft outline of the First Five Year Plan recognized ‘ population policy’ as an ‘essential to planning’ and ‘family planning’ as a ‘step towards improvement in health of mothers and children’.

1952- Launching of the first National Family Planning Programme in India.

1976- Statement of National Population Policy, by Shri K. Singh, Minister of Health and Family planning, to deter population growth and events that contributed to it.

1977- A revised Population Policy Statement was tabled on Parliament. It emphasized the voluntary nature of the family planning programme.The term ‘Family Welfare’ replaced the term ‘Family Planning’.

1983- The National Health Policy emphasized “securing the small family norm, through voluntary efforts and moving towards the goal of population stabilization”

1991-The National Development Council (NDC) appointed a committee with Shri K Karunakaran as the chairperson. The Karunakaran report endorsed by the NDC , in 1993 proposed the formulation of a National Population Policy to take: “a long term holistic view of development, population growth and environmental protection”,“to suggest policies and guidelines” “ a monitoring mechanism with short, medium and long term goals”

1993 - An expert group headed by Dr. M.S. Swaminathan –asked to prepare draft of a National Population Policy to be discussed.

1994 - Report on a ‘ National Population Policy’ by the expert group circulated among members, and comments sought from the state and central agencies

1997 - On 50th anniversary of Indian independence , Prime Minister, Gujral promised to announce a National Population Policy in near future.

1999 - Another round of consultation in 1998, and another draft finalized and placed before the Cabinet in March, 1999.Cabinet appointed a Group of Ministers (GOM) headed by Deputy Chairman, Planning Commission, to examine the draft.The GOM then finalised a draft, placed before the Cabinet, discussed on 19th November 1999.

BACKGROUND OF THE 1976 POPULATION POLICY:

In 1976, with India’s population growing rapidly, the Emergency extended for another year.

Minister of Health and Family Planning , Kartar Singh, announced National Population Policy, to deter population growth.

The policy hoped to reduce the nation’s hardships, established how incentives would be allocated to those who participate in population management efforts, and sought to reduce the nation’s birth rate from 35 to 25 per 1000 by 1984.

The policy also acknowledged that the country’s population growth concerns could not wait for increased development and education to result in fertility drop.

It concentrated resources at one place, more of the health professionals were being used to reach sterilization goals, rather than other services towards patient welfare.

OBJECTIVES OF THE NATIONAL POPULATION POLICY-2000:

Immediate Objective

To address the unmet needs for contraception, health care infrastructure and health personnel and to provide integrated service delivery for basic reproductive and child health care.

Cont…..

Medium- term Objective

To bring the TFR to replacement level by 2010, through vigorous implication of inter-sectorial operational strategies.

Cont…..

Long – term Objective

To achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development and environmental protection.

NATIONAL SOCIO-DEMOGRAPHIC GOALS FOR

2010: Address the unmet needs for basic

RCH services, supplies and infrastructure.

Make school education up to age 14 years free and compulsory, and reduce drop outs rate from primary and secondary school levels to below 20 percent for both boys and girls.

Reduce IMR to 30/1000 live births

Reduce maternal mortality ratio (MMR) to less than 100 per 1000 live births

Achieve universal immunization of children against all Vaccine Preventable Disease (VPD).

Promote delayed marriage for girls, at age not less than 18,and preferable after 20 years.

Achieve 80% institutional delivery and 100% by trained personnels

Achieve universal access to information/ counseling services for fertility regulation and contraceptive with wide basket of choices

Achieve 100% registration of births, deaths, marriage, and pregnancy.

Containment of AIDS, and greater integration between the management of AIDS and STD.

Prevention and control of communicable diseases.

Integration of Indian system of medicine in provision of RCH services, and in reaching out to households.

Promote small family norm to achieve replacement level of Total Fertility Rate 2.1.

Bring about convergence in implementation of related social sector programmes so that family welfare become people centered programme.

MAJOR STRATEGIC THEMES FOR THE NPP-2000

Strategic themes must be simultaneously pursued in “stand alone” or intersectoral programmes in order to achieve the national socio-demographic goals for 2010. Following strategic themes are presented in the policy:

1.Decentralized planning and programme implementation

2.Availability of services delivery at village levels

3.Empowering women for improved health and nutrition

4.Child survival and child health

5.Meeting the unmet needs for Family Welfare Services

6 Greater emphasis for underserved population group

Urban Slums

Tribal communities, Hill Area populations and displaced and migrant populations

Adolescents

Increased participation of men in planned parenthood

7.Diverse health care providers

8.Collaboration with the commitments from private agencies and NGOs

9. Involvement of Indian system of medicine in delivery of RCH services

10. Contraceptive technology and research in RCH

11. Providing health care and support for the older population

12.Information, Education and Communication .

LEGISLATION, PUBLIC SUPPORT & NEW STRUCTURES:

LEGISLATION:As a motivational measure, in order to enable state governments to fearlessly and effectively pursue the agenda for population stabilisation contained in the National Population Policy, 2000, one legislation is considered necessary. It is recommended that the 42nd Constitutional Amendment that freezes till 2001, the number of seats to the Lok Sabha and the Rajya Sabha based on the 1971 Census be extended up to 2026

PUBLIC SUPPORT:Demonstration of strong support to the small family norm, as well as personal example, by political, community, business, professional and religious leaders, media and film stars, sports personalities, and opinion makers, will enhance its acceptance throughout society. The government will actively enlist their support in concrete ways

NEW STRUCTURES:The NPP 2000 is to be largely implemented and managed at panchayat and nagar palika levels, in coordination with the concerned state/Union Territory administrations. Accordingly, the specific situation in each state/UT must be kept in mind. This will require comprehensive and multisectoral coordination of planning and implementation between health and family welfare on the one hand, along with schemes for education, nutrition, women and child development, safe drinking water, sanitation, rural roads, communications, transportation, housing, forestry development, environmental protection, and urban development. Accordingly, the following structures are recommended:

NATIONAL COMMISSION ON POPULATION

Formulated on 11th May 2000,Reconstituted on Feb 2005 Members are Chairman,Deputy Chairman,2 vice Chairman,Secretary.A National Commission on Population, presided over by the Prime Minister, will have the Chief Ministers of all states and UTs, and the Central Minister in charge of the Department of Family Welfare and other concerned Central Ministries and Departments, for example Department of Woman and Child Development,Department of Education, Department of Social Justice and Empowerment in the Ministry of HRD, Ministry of Rural Development, Ministry of Environment and Forest, and others as necessary, and reputed demographers, public health professionals, and NGOs as members. This Commission will oversee and review implementation of policy. The Commission Secretariat will be provided by the Department of Family Welfare.

Aims:

To review, monitor and give directions for the implementation of the National Population Policy

To promote synergy between demographic, educational, environmental and developmental programmes.

To promote intersectoral co-ordination in planning and implementation.

First Meeting-23rd July 2005- Survey of all District to identify the weakness in Health Care Delivery System.

State / UT Commissions on Population:Each state and UT may consider having a State / UT Commission on Population,presided over by the Chief Minister, on the analogy of the National Commission, tolikewise oversee and review implementation of the NPP 2000 in the state / UT.

Coordination Cell in the Planning Commission:The Planning Commission will have a Coordination Cell for inter-sectoral coordination between Ministries for enhancing performance, particularly in States/UTs needing special attention on account of adverse demographic and human development indicators.

 Technology Mission in the Department of Family Welfare:To enhance performance, particularly in states with currently below average sociodemographic indices that need focused attention, a Technology Mission in the Department of Family Welfare will be established to provide technology support in respect of design and monitoring of projets and programmes for reproductive and child health, as well as for IEC campaigns.

FUNDING, PROMOTIONAL AND MOTIVATIONAL MEASURES FOR

ADOPTION OF THE SMALL FAMILY NORM

FUNDING:The programmes, projects and schemes premised on the goals and objectives of the NPP 2000, and indeed all efforts at population stabilisation, will be adequately funded in view of their critical importance to national development. Preventive and promotive services such as ante-natal and post-natal care for women, immunisation for children, and contraception will continue to be subsidised for all those who need the services. Priority in allocation of funds will be given to improving health care infrastructure at the community and primary health centres, subcentre and village levels. Critical gaps in manpower will be remedied through redeployment, particularly in under-served and inaccessible areas, and referral linkages will be improved. In order to implement immediately the Action Plan, it would be necessary to double the annual budget of the Department of Family Welfare to enable government to address the shortfall in unmet needs for health care infrastructure, services and supplies Even though the annual budget for population stabilisation activities assigned to the Department of Family Welfare has increased over the years, at least 50 percent of the budgetary outlay is deployed towards non-plan activities (recurring expenditures for maintenance of health care infrastructure in the states and UTs,and towards salaries).

To illustrate, of the annual budget of Rs. 2920 crores for 1999-2000, nearly Rs 1500 crores is allocated towards non-plan activities. Only the remaining 50 percent becomes available for genuine plan activities, including procurement of supplies and equipment. For these reasons, since 1980 the Department of Family Welfare has been unable to revise norms of operational costs of health infrastructure, which in turn has impacted directly the quality of care and outreach of services provided.

PROMOTIONAL AND MOTIVATIONAL MEASURES FOR ADOPTION OF THE

SMALL FAMILY NORM

(i) Panchayats and Zila Parishads will be rewarded and honoured for exemplary performance in universalising the small family norm, achieving reductions in infant mortality and birth rates, and promoting literacy with completion of primary schooling.

(ii) The Balika Samridhi Yojana run by the Department of Women and Child Development, to promote survival and care of the girl child, will continue. A cash incentive of Rs. 500 is awarded at the birth of the girl child of birth order 1 or 2.

(iii) Maternity Benefit Scheme run by the Department of Rural Development will continue. A cash incentive of Rs. 500 is awarded to mothers who have their first child after 19 years of age, for birth of the first or second child only. Disbursement of the cash award will in future be linked to compliance with ante-natal check up, institutional delivery by trained birth attendant, registration of birth and BCG immunisation.

(iv) A Family Welfare-linked Health Insurance Plan will be established. Couples below the poverty line, who undergo sterilisation with not more than two living children, would become eligible (along with children) for health insurance (for hospitalisation) not exceeding Rs. 5000, and a personal accident insurance cover for the spouse undergoing sterilisation.

(v) Couples below the poverty line, who marry after the legal age of marriage, register the marriage, have their first child after the mother reaches the age of 21,accept the small family norm, and adopt a terminal method after the birth of thesecond child, will be rewarded.

(vi) A revolving fund will be set up for income-generating activities by village-level self help groups, who provide community-level health care services.

(vii) Crèches and child care centres will be opened in rural areas and urban slums.This will facilitate and promote participation of women in paid employment

(viii) A wider, affordable choice of contraceptives will be made accessible at diverse delivery points, with counseling services to enable acceptors to exercise voluntary and informed consent.

(ix) Facilities for safe abortion will be strengthened and expanded.

(x) Products and services will be made affordable through innovative social marketing schemes.

(xi) Local entrepreneurs at village levels will be provided soft loans and encouraged to run ambulance services to supplement the existing arrangements for referral transportation.

(xii) Increased vocational training schemes for girls, leading to self-employment will be encouraged.

(xiii) Strict enforcement of Child Marriage Restraint Act, 1976.

(xiv) Strict enforcement of the Pre-Natal Diagnostic Techniques Act, 1994.

(xv) Soft loans to ensure mobility of the ANMs will be increased.

(xvi) The 42nd Constitutional Amendment has frozen the number of representatives in the Lok Sabha (on the basis of population) at 1971 Census levels. The freeze is currently valid until 2001, and has served as an incentive for State Governments to fearlessly pursue the agenda for population stabilisation.This freeze needs to be extended until 2026.

OPERATIONAL STRATEGIES:

Village self help groups to organize and provide basic services for RCH care , combined with the on going ICDS scheme.

Implement at village levels, a one-stop integrated and coordinated service delivery package for basic health care, family planning and MCH care.

Where ever these village self help groups have not developed, community midwives, practitioners of ISM, retired school teachers may be organized to perform similar functions.

At village level, the Anganwadi centre may become the pivot of basic health care activities, contraceptive counseling and supply, nutrition education and supplementation and pre school activities.

Establishment of a maternity hut in every village with equipments, supplies and medicines for safe delivery.

Trained birth attendants and traditional dais should be made familiar with emergency and referral procedures.

Provide wider basket of choices in contraception through innovative social marketing schemes to reach household levels.

Improve district, sub-district and panchayat level health management.

Strengthen Community Health Centres (CHC) and Primary Health Centres to provide comprehensive essential and emergency obstetric and neo-natal care.

Strengthening skills of health personnels through various training activities.

Focus attention on men to promote the small family norm.

Sensitize train and equip rural and urban health centres and hospitals towards providing geriatric health care

STATE POPULATION POLICIES:

Population Management falls in the concurrent list of activities envisaged in the constitutional framework of India – but state responsibility to a large extent.

Thus a new phenomena of policy formulation at state level has begun which may reintensify the efforts of Union Government.

In 1997 - land mark in the history of population policy in India, the State Government of Andhra Pradesh formulated a very well articulated Andhra Pradesh Population Policy, well before the NPP-2000.

Followed in quick succession by several other states.

Till date 17 states and UTs have formulated their state population policies.

MAHARASHTRA POPULATION POLICY:

The population of Maharashtra as per census 2011 is 11.23 crores, which forms 9% of the total population of the country.

The population of Maharashtra doubled from 1901-1961.

Next double came from 1961-1991.

From 1991-2011 ,a decline , 22.73 to 15.99

Objectives of the policy:

1. To reduce Total Fertility Rate ( TFR) from 2.5 to 2.1 upto to 2004.

2. To reduce Infant Mortality & Maternal Mortality Significantly

3. To improve comprehensive health of family.

4. To provide special services to tribal area, small size villages ; and urban slum areas

Proposed activities and interventions

Acceptance of small family norm Small family has been defined as one with “ two children”.

Compulsory acceptance of two child norm for individual benefits in government jobs.

- For subsidies

- Condition for government jobs- Govt. facilities will be extended to such families

- Medical claims for these families only.

3.Performance of family welfare in their area to be part of officer’s assessment at various levels.

4. Improving accessibility of health services

- 2 yrs compulsory post-PG rural service

- Prompt implementation of service rules

- Infrastructure development for NSV

- “Matru Suraksha Wahini” for prompt referral in difficult areas

5.Organization of FW camps with financial assistance from cooperative societies, sugar factories & other industrial establishments.

6. Strict implementation of existing acts and policies such as child marriage act, prenatal sex determination act, birth and death registration act.

7. Acceptance of small policy norm as a condition for qualifying for elections to various bodies such as Zilla Parishad, Panchayat Samiti, Cooperative societies etc.

8. Jagruk Grampanchayat Yojana 9. Improving quality of services –

incentives

10. Strengthening ante, intra, post-natal services

11. Strengthening services in urban areas12. MCH centers at village level13. Constituting Mahila Vikas Groups under

the chairmanship of Hon. CM’s wife at state level and Guardian minister’s wife at district level.

14. Sudharit Savitribai Fule Kanya Kalyan Yojana

- For BPL families- Sterilization on one daughter-Rs. 10,000 + 5,000 FD- Sterilization on two daughters-

Rs. 5,000 + 5,000 FD

Health Care Infrastructure

Public SectorDistrict

CHC (4 PHC)

PHC-(Referral Unit for 6 Sub-Centers)

Sub center

Cont…..Population Distribution

• Hilly- 5000• Plains- 3000

Sub center

• Hilly- 30,000• Plains- 20,000PHC

• Hilly- 1,20,000

• Plains- 80,000CHC

Programmes will plan to implement in coming days

Revised national population policy aimed at improving quality of life in the country.

- Daily Times on 6th April 2010

The revised policy focusing on improving health, managing urbanization and gender-sensitive development.

 Population Programmes/Schemes

Basic infrastructure

-Sub Centre

-PHC

-CHC

Janani Suraksha Yojana

Family Welfare Linked Health Insurance Scheme

Compensation for acceptor of Sterilization

Conclusion

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